National Provider Identifier Database

NORTHERN ARIZONA PHARMACY LLC
Community/Retail Pharmacy

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.


Contact Information

NORTHERN ARIZONA PHARMACY LLC
12075 E STATE ROUTE 69
SUITE E
DEWEY-HUMBOLDT, AZ86327
Phone: 928-515-0455
Fax: 928-515-0456
Website:
Specialty Taxonomy Code
* Community/Retail Pharmacy 3336C0003X

* Indicates primary specialty

NPI Profile & details for NORTHERN ARIZONA PHARMACY LLC

NPI Number 1902445802
Legal business name
LBN
NORTHERN ARIZONA PHARMACY LLC
Authorized official JASON DYKSTRA - (MANAGER)
Entity Organization
Organization subpart No
Enumeration date 12/26/2019
Last updated 12/08/2020 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ Medicaid: 003672

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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